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Gynecomastia /ˌɡaɪnɨkɵˈmæstiə/ is a common condition characterized by the benign enlargement of breast tissue in males.[1][2][a] It may occur transiently in newborns. Half or more of adolescent boys have some breast development during puberty.[1][4] Newborn and adolescent males frequently experience temporary gynecomastia due to the influence of maternal hormones and hormonal changes during puberty, respectively.

Gynecomastia may arise as an abnormal condition associated with disease, such as Klinefelter syndrome, metabolic disorders, as a side-effect of medication, or as a result of the natural decrease of testosterone production in older males.[1][5][6] In adolescent boys, the condition is often a source of psychological distress; however, 75% of pubertal gynecomastia cases resolve within two years of onset without treatment.[2]

Causes[edit]

Physiologic[edit]
Many newborn infants of both sexes show breast development at birth or in the first weeks of life.[11] During pregnancy, the placenta converts the hormones DHEA and DHEA sulfate to the estrogens estrone and estradiol, respectively; after these estrogens are produced by the placenta, they are transferred into the baby's circulation thereby leading to temporary gynecomastia in the baby.[7][12] In some infants fluid ("witch's milk") can be expressed.[8] The temporary gynecomastia seen in newborn babies usually resolves after two or three weeks.[7] Gynecomastia in adolescents usually starts between the ages of ten and twelve and commonly goes away after eighteen months.[7] Declining testosterone levels and an increase in the level of subcutaneous fatty tissue seen as part of the normal aging process can lead to gynecomastia in older men. This is also known as senile gynecomastia.[7] Increased fatty tissue in these men leads to increased conversion of androgenic hormones such as testosterone to estrogens.[7] When the human body is deprived of adequate nutrition, testosterone levels drop while the adrenal glands continue to produce estrogens thereby causing a hormonal imbalance.[7] Gynecomastia can also occur once normal nutrition is restarted (this is known as refeeding gynecomastia).[7]

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